Experts Determine the U.S. Needs Stronger Safety Surveillance

Workplace injuries and illnesses are undercounted, and the United States needs a more robust occupational safety and health surveillance system, a panel of experts concluded in a recently issued report.

The National Institute for Occupational Safety and Health (NIOSH) should lead a collaborative effort with the Labor Department’s Bureau of Labor Statistics (BLS), OSHA, and states to establish and strengthen regional occupational safety and health surveillance programs, according to a report from the National Academies of Sciences, Engineering, and Medicine.

The report, A Smarter National Surveillance System for Occupational Safety and Health in the 21st Century, included a wide range of suggestions for collecting data from both existing and potentially new sources about workplace injuries and illnesses.

If the panel’s recommendations were implemented, they could have significant impacts on employers, healthcare providers, insurers, federal agencies and state governments, as well as workers.

The panel recommended implementing a household survey to record occupational injuries and illnesses, obtaining information directly from workers, to fill in gaps in the data from employer-based injury reporting.

Wide-Ranging Recommendations

The panel’s also recommended that:

• BLS routinely collect detailed case and demographic data for injuries and illnesses resulting in job transfer or restricted duty, as well as those resulting in days away from work;
• OSHA amend its injury and illness recording requirements, making the type of employment arrangement (such as traditional, independent contractor, temporary agency worker, or on-call worker) and race and ethnicity mandatory data elements on the OSHA Form 301;
• NIOSH combine information from existing occupational disease surveillance systems with information from cancer registries and other datasets to provide a more comprehensive annual report on the extent of occupational illnesses;
• NIOSH collaborate more closely with Centers for Disease Control and Prevention’s (CDC) infectious disease surveillance programs to improve documentation of endemic and epidemic infectious disease related to work;
• NIOSH lead an effort to create and strengthen state-based workplace safety and health surveillance programs;
• OSHA and NIOSH work with stakeholders to develop software and other tools and to facilitate establishment-level analysis of injury data with specific attention to enabling effective use by employers, as well as others, to identify hazards and job-specific issues;
• NIOSH and OSHA explore and promote the expanded use of workers’ compensation data for occupational injury and illness surveillance and the development of surveillance to track injury and illness outcomes, including return to work and disability;
• NIOSH and OSHA collaborate with states in the development of surveillance systems to capture the cost of work-related injury and illness, measuring work-related disability and return-to-work outcomes, and assessing the adequacy of benefits administered through workers’ compensation insurance programs;
• States develop and enhance the use of workers’ compensation data for state-based occupational injury and illness surveillance and prevention activities
• The Department of Health and Human Services designate industry and occupation as core demographic variables collected in both federal health surveys and public health surveillance systems; and
• NIOSH lead an effort in changing rules to require the collection of industry and occupational information in electronic health records.

Goals

The purpose for collecting this information would be for NIOSH and the DOL agencies to:

• Define and accurately measure the burden of workplace injuries and illnesses that already exists,
• Measure the progress over time in reducing those burdens and improving worker safety and health,
• Improve the allocation of existing resources to achieve better health outcomes, and
• Better inform policy priorities.

The panel was led by Edward Shortliffe, professor of biomedical informatics at Arizona State University, and included several academics, as well as Scott A. Mugno, President Trump’s nominee to head OSHA, and Peg Seminario, director of occupational safety and health for the AFL-CIO.

The study and report were funded by the BLS, NIOSH, and OSHA; however, the agencies have not proposed and may not propose implementing any of the report’s recommendations.